Insurers push back on life-saving, but expensive drugs
Posted on September 18, 2007
Filed Under All, My Brain, New Life |
A month ago, my neuro-oncology team at UCSF and I discussed a switch in chemotherapy drugs. The UCSF team has been very encouraged by clinical tests showing that Avastin has been very effective against glioma - the kind of brain tumor that I have.
Avastin is expensive (not that Temodar or other chemotherapies aren’t) - costing around $8,000 a treatment. Currently, Avastin is only FDA-approved for treating colorectal cancer. So when my neuro-oncology team first proposed the change, my insurer, Aetna refused to pay for it.
They sent me a letter saying that a board-certified anesthesiologist had made this decision. Anesthesiologist? Making life-or-death decisions about my cancer treatment? We have UCSF’s world-class neuro-oncologists saying ‘yes,’ and some anesthesiologist somewhere saying no? Yikes.
The Wall Street Journal has a story this morning about the plight of folks like me. On the one hand, I appreciate efforts to keep health costs down: on the other, this is life or death for me and many other glioma patients. I’ve paid my health care premiums all my working life against the day I’d need therapy like this, and I’m not alone, it would seem. The good news is that the UCSF team finally prevailed with the insurer: I’ve been on Avastin for 2 months and the result has been very encouraging…
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[...] Posted by as Uncategorized Avastin is expensive (not that Temodar or other chemotherapies aren’t) - costing around $8000 a treatment. Currently, Avastin is only FDA-approved for treating colorectal cancer. So when my neuro-oncology team first proposed the change, …article continues at cg brought to you by cancer.medtrials.info and medtrials.info [...]
Chris- The health care system is broken. You should go to the corporate websites of private health insurers and look at the obscene profits and the pay of top oficials. They are incentivised to deny care to folks like you and me. Glad your docs were able to prevail. Bring them a gift for spending countless hours contesting the decision to deny avastin for which they were not paid for their time. I could go on and on but the important fact is you are doing so much better. All the best Stuart
Fantastic, glad they got you what you needed. I have zero medical knowledge, but surely humans are so varied that most blanket medical decisions are going to harm a significant subset of people. Leave it up to the doctor and the patient.
Hopefully your experience will help get rid of this particular blanket rule.
It’s hard to believe that insurance companies can have such miserable morality: letting people die so they can keep the money…
Yuk.